Poor Ovarian Responders Undergoing IVF Using Luteal Ovarian Stimulation Versus Follicular Ovarian Stimulation

Kaohsiung Veterans General Hospital.96 enrolled

Overview

The investigators attempted to compare the clinical outcomes and cumulus genes expression in poor ovarian responders undergoing luteal ovarian stimulation or follicular ovarian stimulation in in vitro fertilization cycles.

Multiple follicular wave theory proposed by Baerwald et al. implied that follicle recruitment may occur in the luteal phase of menstrual cycle. Therefore, luteal phase ovarian stimulation (LPOS) was considered as a potential feasible stimulation method during in vitro fertilization (IVF) cycle. In the beginning, in order to avoid delaying cancer treatment, LPOS was applied for fertility preservation of cancer patients, showing no difference in numbers of oocyte retrieved, mature oocytes and fertilization rate between luteal or follicular phase stimulation. In the recent, LPOS was used for infertility women, suggesting that LPOS owned quite good IVF outcomes. In previous studies, premature luteinizing hormone (LH) surge, a major reason worsening ovarian quality in poor ovarian responders (PORs), was seldom found in LPOS. High progesterone in luteal phase may aid in suppressing premature LH surge. An updated research claimed that numbers of oocyte retrieved, mature oocytes and fertilized oocytes in LPOS significantly increased when compared to follicular ovarian stimulation. Therefore, the investigators presumed that LPOS was a more effective method than follicular stimulation in PORs.

Study Type

INTERVENTIONAL

Allocation

NON_RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Fertilization in Vitro

Interventions

luteal ovarian stimulationOTHER

In the in vitro fertilization cycle, controlled ovarian stimulation was started since the luteal phase.

follicular ovarian stimulationOTHER

In the in vitro fertilization cycle, controlled ovarian stimulation was started since the follicular phase.

Eligibility

Sex: FEMALEMin age: 30 YearsMax age: 45 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Poor ovarian responders (PORs) met the Bologna criteria, having at least two of the three following features: 1. advanced maternal age (≥ 40 years) or any other risk factor for POR, 2. a previous POR (≤ 3 oocytes with a conventional stimulation protocol), and 3. an abnormal ovarian reserve test. An abnormal ovarian reserve test was defined as antral follicle count (AFC) \< 5 or anti-Müllerian hormone (AMH) \< 1 ng/mL in this study. Moreover, two episodes of a previous POR after maximal stimulation alone would be sufficient to define a patient as a POR. Exclusion Criteria: * oophorectomy * exposure to cytotoxic or pelvic irradiation for malignancy * taking herbal drugs or other hormonal agents

Locations (1)

Kaohsiung Veterans General Hospital

Kaohsiung City, Taiwan

Outcomes

Primary Outcomes

oocytes and embryos

retrieved oocytes in number, matured oocytes in number, fertilized oocytes in number, day 3 embryos in number, top-quality day 3 embryos in number

Time frame: through study completion, an average of 1 year

Secondary Outcomes

pregnancy rate

Clinical pregnancy rate

Time frame: Pregnancy will be confirmed 4 weeks after embryo transfer.

genes expression

cumulus cells genes expression

Time frame: through study completion, an average of 1 year

Data from ClinicalTrials.gov

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